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Head To Head

Should healthy volunteers in clinical trials be paid according to risk? Yes

BMJ 2009; 339 doi: (Published 22 October 2009) Cite this as: BMJ 2009;339:b4142
  1. Eleri Jones, barrister1,
  2. Kathleen Liddell, lecturer2
  1. 1Middle Temple, London, EC4Y 9AT
  2. 2Faculty of Law, University of Cambridge, Cambridge CB3 9DZ
  1. Correspondence to: E Jones eleri.jones{at}

    Eleri Jones and Kathleen Liddell argue that objections to paying according to risk are paternalistic, but John Saunders (doi:10.1136/bmj.b4145) thinks that it would lead to people being exposed to unacceptable danger

    The severe reactions experienced by healthy volunteers in the TGN1412 (Northwick Park) trial have led to questions about payment for participation.1 Currently, the dominant view is that only time and expenses should be remunerated. By this logic a healthy volunteer participating in a half day trial at risk of immunological storm is paid the same as a volunteer participating in a half day observational study. This is objectionable for two reasons: firstly, because there should be recognition of a volunteer’s gift to society2 for the higher risks in some trials and, secondly, because it is inconsistent with other practices in society.

    The law and current guidelines

    The law allows volunteers to be paid subject to approval by a research ethics committee.3 In addition, the volunteer must give free and informed consent, yet there has been little judicial guidance on the influences, such as money, that render a …

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